Difficulty stopping urination or loss of control of bladder or bowels.

Unexplained fever, nausea or vomiting.

A history of cancer or unexplained weight loss.

No, I am not experiencing any of the above health issues.Yes, and I have not discussed these health issues with my doctor.Yes, I have one or more of these health issues but have been cleared by my doctor to proceed with this program.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Soft-Tissue Sarcoma

Overview

Soft-tissue sarcoma is a rare type of cancer that develops in the soft tissues that connect and support the body’s organs. These tissues include fat, muscles, nerves, tendons, blood and lymph vessels.

Soft-tissue sarcoma can start anywhere in the body. There are approximately 60 different types of sarcoma. Some soft tissue cancers malignancies do not spread (metastasize), but are locally invasive, such as desmoid tumor (also called aggressive fibromatosis).

The most common soft tissue sarcoma is undifferentiated pleomorphic sarcoma (UPS). We’re not sure where this cancer begins because the cell changes and no longer looks like the cells where the cancer started.

Risk Factors

A risk factor is something that increases your chance of developing a condition or disease such as cancer. Risk factors for soft-tissue sarcoma include:

Certain inherited conditions. Some inherited conditions, such as a nervous system disorder (neurofibromatosis) and a condition called Li-Fraumeni syndrome, can increase the risk for sarcoma.

Previous radiation therapy. Radiation to treat another cancer, such as breast cancer or lymphoma, can cause sarcoma to develop several years after radiation exposure. The tumor typically grows in the body area that was treated with radiation. The risk of sarcoma due to previous radiation therapy is low.

Symptoms

It is important to know the possible indications of soft-tissue sarcoma so we can evaluate your symptoms as soon as possible.

More than half of sarcomas develop in your leg or arm, so the first sign is usually a painless lump that can be felt under the skin. The lump may have grown over a period of weeks or months. Because soft-tissue sarcoma starts in soft, flexible tissues that a growing tumor can easily push aside, a tumor can grow large before it causes symptoms.

For sarcomas that develop elsewhere, such as in the abdomen, you may experience pain or symptoms caused by a blockage in your stomach or intestines. If symptoms of the sarcoma are present, they can include:

A new lump or swelling

A lump that is growing and may or may not be painful

Abdominal pain that worsens over time

Pain or soreness as the tumor presses on nerves and muscles

Feeling of fullness

Trouble breathing

These symptoms may be caused by a problem other than cancer. It is important that we assess your symptoms to figure out what is causing them.

Diagnosis

We have a number of ways to help diagnose soft-tissue sarcoma. We start by asking about your medical history. Questions may include whether you have any risk factors and how long you have experienced symptoms. We perform a physical exam to check for lumps and other possible signs of cancer. We may then use various tests to diagnose the disease:

Biopsy. We remove a small amount of tissue from the tumor. A sample may be extracted using a needle through the skin, or we may remove all or part of the tumor during a surgical procedure. We examine the tissue under the microscope to determine whether the tumor is benign or malignant and the exact type.

Ultrasound. An ultrasound can show a tumor by using sound waves to create a picture of internal organs and structures.

Computed tomography (CT) scan. During a CT scan, a machine rotates around you to take many pictures of your body. These detailed images can provide specific information about the size, shape, and location of the cancer.

Magnetic resonance imaging (MRI). Radio waves and strong magnets help create very detailed pictures that show the extent of the cancer.

PET/CT scan: A radioactive tracer agent is injected into the bloodstream. The tracer may be absorbed by the primary tumor and at any metastatic sites of cancer spread throughout the whole body.

Bone scan. Sometimes another nuclear medicine procedures, known as a bone scan, is utilized to evaluate for spread to the bones or skeleton.

Other tests may be done to determine whether the cancer has spread to your lungs or other parts of your body.

Staging

We use information gathered from the various diagnostic tests to determine the type of sarcoma you have and how much it has spread. Knowing the extent (stage) of your cancer helps us determine what treatment plan is best for you. We consider a number of factors when staging your cancer. These include:

The tumor’s grade, a measurement of how likely it is to spread (higher-grade tumors grow and spread more rapidly than lower-grade tumors).

The size of the tumor.

Whether it is deep or near your skin’s surface.

Whether it has spread to lymph nodes or other parts of your body. For a sarcoma, it is rare for cancer to spread to the lymph nodes.

The stages range from 1 to 4, with stage 1 being a small tumor that has not spread and stage 4 referring to an aggressive tumor that has spread. The stages for soft-tissue sarcoma are:

Stage 1A. The tumor is 5 centimeters (cm), about 2 inches, or smaller across and has not spread.

Stage 1B. The tumor is larger than 5 cm and has not spread.

Stage 2A. The tumor is 5 cm or smaller and has not spread, but the grade is higher than for stage 1.

Stage 2B. The tumor is larger than 5 cm and has not spread, but the grade is higher than for stage 1.

Stage 3. The tumor is larger than 5 cm and high-grade. Or the tumor is any size and any grade and has spread to lymph nodes near the tumor.

Stage 4. The tumor is any size and any grade and has spread to other parts of the body. The cancer may or may not have spread to nearby lymph nodes.

Some types of soft-tissue sarcoma are categorized differently. For example, Kaposi sarcoma and gastrointestinal stromal tumor (a type of sarcoma that develops in the digestive tract) use risk categories instead of stages.

Treatment

After we learn everything we can about your soft-tissue sarcoma, we discuss the treatment options and develop a plan that is right for you. Treatment options for soft-tissue sarcoma include surgery, radiation therapy, and, sometimes, chemotherapy. Targeted therapy is also an option for some typesof soft-tissue sarcoma.

Follow-Up Care

Follow-up appointments are an important part of your cancer care. During these regular visits, we do physical exams and check for symptoms that may be caused by cancer.

Clinical trials

We are always looking for new and better ways to treat soft-tissue sarcoma. Clinical trials are research studies that test new treatments or procedures that may prove better than standard treatments. We will talk with you about whether a clinical trial may be right for you.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.